[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

Re: [IP] Support of medical doctors, nurses, etc (long -- sorry)

To continue the discussion a little further though...I fully believe, Judy, Barbara
and any other health care workers on this list that you work with the best
intentions and try hard to be open minded.  And many other health care workers do
too although many are misguided in their knowledge about "best" strategies.  BUT  I
have been mistreated too many times for coincidence.

I'm convinced that the problem is underlying assumptions made at large in society
and through the medical training process about diabetics.  As a teacher in the
California Community College System I think I encounter some of the problems health
care workers face with students.  And I've heard many teachers over the years moan
about apparent "lack of motivation" and "lack of compliance" from a highly diverse
group of students most of whom face real risks as students that four year
university students (especially the higher level university students -- i.e.
Berkeley, Stanford, etc.) just don't face.  I know that my students, especially
early in the semester, often appear unmotivated, flaky, etc.  I also know that
early in the semester a high portion of the work looks nearly illiterate to someone
with a university background.  (My 7th graders when I taught in a fairly diverse
public school were more fluent in their writing than my college students often
start out).

BUT every semester for the past ten years I've discovered that except for a very
very few students who are just in the wrong place at the wrong time (and often
return later),  my students become motivated and instead of being compliant, take
the initiative in their own education when we (me, them and the class) address the
reasons for their behavior and help them understand the bridge they are trying to
cross.   It takes a lot of work though to accomplish this and an enormous amount of
communication and feedback from both ends.  Part of this is about putting students
in control of their own studenting -- something middle class university kids have
often been taught since kindergarten but that all other students in our society
have systemically squeezed out of them at every level of education.  It is a really
all consuming task.

I am impressed by the many very motivated people on this list who have really taken
control of their lives.  My sneaking suspicion though is that most of us have some
combination of the following characteristics:   well -educated, middle class or
come from families who have chosen less well paying jobs in favor of vocations,
have had some seminal experience or mentor which taught us how to accomplish this
kind of control, have a thoughtful and well informed family support system of some
kind readily available and comfortable to work with, have generous and reliable
medical insurance coverage that spans our time with diabetes.   Most human beings
in America today do not have these factors in their lives.  I'd be thrilled though
if we all did or if we were all provided with the means to obtain them.

Given the system of diabetic control I learned at age 11 and the medical care I
have often received, I wonder how many people are actually able to stick to an ADA
diet without some of the above help?  It's not an easy thing to do though it was
doable.  Imagine, though, that you don't see or feel the value of it?  If you are
someone who often vows not to procrastinate or to write letters more often or be
more responsible about cleaning the house, you might consider what little tricks
aid you when you succeed and what supports are missing when you fail.  I know
students, for instance, need frequent check ins, need to see what they've done well
and need to see themselves become smarter about understanding the medium they are
working with (and the cause and effects)  so that they can feel like they have the
potential to accomplish things in the future.  From Michael's posts, Lily sounds
like she is learning to manage her diabetes in exactly this way -- same with

I think that a huge number of diabetics are written off by the health care system
as "non compliant".  So much so in fact that sometimes when I am trying to comply
and am having genuine medical difficulties, I have found that I am dismissed
instead of helped.  Think about how few Americans can even manage a simple diet to
loose weight?  Why do we expect that diagnosing someone as diabetic will change all
those life behaviors?  At the same time, why do we assume that we can't help
somebody who can't do it themselves through the long difficult process of becoming
motivated and self reliant?  Yes, it requires super human patience.  Yes, it may
require between an hour and 100 hours of help a week per patient.  Yes, it may
require health care workers to learn how to speak across all the kinds of cultural
divides (race, class and much more specific ones) in our culture.  But we are
talking about people's lives here!

Many people on this list have expressed their joy and amazement at feeling so well
on the pump and under good control.  I've had a pump for so long that I had nearly
forgotten the difference it makes sometimes.  If it really feels so good, someone
asked quite a while ago, why don't all those non compliant people want it?  I've
heard tired old (I do not mean old in age but old in teaching motivation -- in the
community college world the two frequently do not correspond) complain that
students don't want to succeed.  But how can people who have no concept of what
success is quite about and who only know that they don't know how to get there
imagine for themselves and believe a few others when they say that this is
possible?    I guess I am concerned here that in the zeal of the converted we may
forget that what divides us from people not receiving good health care and not able
to take charge of diabetes is not our moral superiority but perhaps our ability to
make the most of resources (of all kinds -- $, but many others as well) that others
may lack.  I think the medical profession might be more successful with all those
non compliant diabetics if they could learn (from day one of each health care
workers education) to understand more about the individual patients and the
obstacles to their success.  I believe that many health care workers intend the
best.  I also believe that most are hampered by there ideas from actually carrying
out all of the best they could do.  I also wonder what role the rest of us might
play in little ways in helping the world around us think about these assumptions.

Sorry for the diatribe -- I had a discussion with an at risk student the other day
before reading my e-mail and was just stunned by the similarities.  What do the
rest of you think?


Becky Draper wrote:

> Hi Judy-
> Sorry to have offended you.  I hope you continue to be a member of this
> list as your posts are always informative.
> I'm probably the culprit who coined those nicknames.  They only applied
> to 2 health professionals that I ran across in my lifetime of diabetes
> that were pretty clueless.  I didn't want to use their real names, so I
> made up descriptive nicknames for them.  I certainly didn't intend for
> these nicknames to encompass ALL health care professionals.  I have
> encountered many health care professionals who were exceptional and
> caring.  But these 2 individuals....well you probably read my posts
> about them.
> I looked at it from the stand point of blowing off a little steam.
> After all, we all need to do that now and then to stay healthy right?
> I figured this group of people would certainly understand my dilemma
> when I explained what happened in my encounters with Nurse Ratchet and
> Dr. Death.  I still believe these 2 people earned the nicknames I
> bestowed upon them.
> Please don't take this personally.  No harm was intended.
> thanks,
> Becky D.
> JUDY102 wrote:
> >
> > I would personally appreciate it if we could keep this forum in a more
> > positive tone.  I get tired of rereading "Nurse Ratchet and Dr. Death"  It's
> > old and tired.  I work very hard at nursing and am proud of what we do.  No
> > profession is without its faults.  We are a minority with a very complicated
> > disease.  If we could just quit with the name calling, I can enjoy my e-mails
> > again and feel like a welcome participant and not a pariah.  Thankyou for a
> > minute of your time.  I will help in anyway I can.
> > Judy P. (RN and proud of my work)
> > ----------------------------------------------------------
> > Insulin-Pumpers website http://www.bizsystems.com/Diabetes/
> > For subscribe / unsubscribe information,
> > send the next two lines in a message
> > info
> > end
> > to the e-mail address: email @ redacted
> --
> Becky Draper
> Hammond, WI
> email @ redacted
> ----------------------------------------------------------
> Insulin-Pumpers website http://www.bizsystems.com/Diabetes/
> For subscribe / unsubscribe information,
> send the next two lines in a message
> info
> end
> to the e-mail address: email @ redacted

Insulin-Pumpers website http://www.bizsystems.com/Diabetes/
For subscribe / unsubscribe information,
send the next two lines in a message
to the e-mail address: email @ redacted